Symptoms

Main symptom is a painful, red, swollen area around the nail, often at the cuticle or at the site of a hangnail or other injury. There may be pus-filled blisters, especially with a bacterial infection.

Bacteria causes the condition to come on suddenly. If all or part of the infection is due to a fungus, it tends to occur more slowly.

Nail changes may occur. For example, the nail may look detached, abnormally shaped, or have an unusual color.

If the infection spreads to the rest of the body, symptoms may include:

Fever, chills

Development of red streaks along the skin

General ill feeling

Joint pain

Muscle pain

Exams and Tests

The health care provider can usually diagnose this condition by simply looking at the sore skin.

Pus or fluid may be drained and sent to a laboratory to determine what type of bacteria or fungus is causing the infection.

Treatment

If you have bacterial paronychia, soaking your nail in hot water 2 or 3 times a day helps reduce swelling and pain.

Your provider may prescribe oral antibiotics. In severe cases, your provider may cut and drain the sore with a sharp instrument. Part of the nail may need to be removed.

If you have fungal paronychia, your provider may prescribe antifungal medicine. Keep your hands dry and apply a skin-drying substance, such as Castellani paint (phenol).

Outlook (Prognosis)

Paronychia usually responds well to treatment. But, fungal infections may last for several months.

Prevention

Avoid damaging the nails or fingertips. Because the nails grow slowly, an injury can last for months.

DO NOT bite or pick the nails.

Protect the nails from exposure to detergents and chemicals by using rubber or plastic gloves. Gloves with cotton liners are best.

Bring your own manicure tools to nail salons and do not allow the manicurist to work on your clothes.

To minimize the risk of damage to the nails:

Keep the nails smooth and trim them weekly.

Trim the toenails about once a month.

Use sharp manicure scissors or clippers for trimming fingernails and toenails, and an emery board for smoothing the edges.

Trim nails after bathing, when they are softer.

Trim fingernails with a slightly rounded edge. Trim toenails straight across and do not cut them too short.

DO NOT trim cuticles or use cuticle removers. Cuticle removers can damage the skin around the nail. Trimming the cuticle damages the skin at the base of the nail. This can allow germs to enter, which can lead to infection.

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